Epidemiology
Young STEMI patients have nearly double the Lp(a) of middle-aged STEMI patients in a 287-patient single-centre study (Cardiovasc J Afr 2024)
Original title: Comparison of serum lipoprotein(a) levels in young and middle-aged patients presenting for the first time with ST-elevation myocardial infarction: a single-centre study
This retrospective single-centre study compared 287 first-time ST-elevation myocardial infarction (STEMI) patients aged 20-65, split into a young group (20-45 years, n = 111) and a middle-aged group (46-65 years, n = 176). The young group had significantly higher rates of smoking (89.2% vs. 73.9%), family history of coronary artery disease (67.6% vs. 45.5%), and serum Lp(a) (38.1 vs. 23.5 mg/dL, p < 0.001), along with higher triglycerides, better ejection fraction, and more single-vessel disease than the middle-aged group. On multivariable logistic regression, family history (odds ratio 2.073, 95% CI 1.210-3.549), low HDL cholesterol (odds ratio 1.032, 95% CI 1.003-1.062), and elevated Lp(a) (odds ratio 1.981, 95% CI 1.871-3.991) were independent risk factors for STEMI in the young group. The findings support measuring Lp(a) in young patients at high cardiovascular risk, given its markedly higher levels and independent contribution to premature STEMI.
Original abstract
Background: Lipoprotein(a) [Lp(a) ] is associated with coronary artery disease due to its atherogenic and thrombogenic nature. In this study, we aimed to compare the level of Lp(a) in young and middle-aged patients with ST-elevation myocardial infarction (STEMI).
Methods: This retrospective study included 287 patients aged 20-65 years who presented to the emergency department for the first time due to STEMI. The patients were divided into two groups: 20-45 years (young group, n = 111) and 46-65 years (middle-aged group, n = 176). The groups were compared in terms of demographic characteristics, co-morbidities and laboratory findings.
Results: In the young group, smoking (99, 89.2% vs 130, 73.9%; p = 0.001), family history of coronary artery disease (75, 67.6% vs 80, 45.5; p < 0.001), serum Lp(a) level [38.1 ± 27.9 (93 ± 68) vs 23.5 ± 23.2 mg/dl (57 ± 56 nmol/l); p < 0.001], triglyceride level [219.1 ± 231.9 (2.48 ± 2.62) vs 170.2 ± 105.6 mg/dl (1.92 ± 1.19 mmol/l); p = 0.018), ejection fraction (52.4 ± 6.1 vs 47.2 ± 7.7%; p = 0.004) and single-vessel disease (83, 74.8% vs 110, 62.5%; p = 0.031) were higher than in the middle-aged group. In multivariable logistic regression analyses, family history (OR: 2.073, 95% CI: 1.210-3.549; p = 0.008), low high-density lipoprotin cholesterol level (OR: 1.032, 95% CI: 1.003-1.062; p = 0.029) and Lp(a) elevation (OR: 1.981, 95% CI: 1.871-3.991; p < 0.001) were possible independent risk factors for STEMI in young patients.
Conclusion: Lp(a) level was found to be a higher and a possible independent risk factor in young patients who presented with STEMI for the first time, compared to the middle-aged patient group. Lp(a) is a highly atherogenic molecule and it has been associated with stroke, heart failure, aortic stenosis, as well as coronary artery disease. Measurement of Lp(a) levels may be recommended in young patients with high cardiovascular risk.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.